title: A case report of the cascade filtration system: a safe and effective method for low-density lipoprotein apheresis during pregnancy.
abstract: Women with familial hypercholesterolemia (FH) should be treated effectively during pregnancy, as elevated low-density lipoprotein cholesterol (LDL-C) levels may result in life-threatening consequences. Hydroxymethylglutaryl-coenzyme A reductase inhibitors are contraindicated during pregnancy, therefore LDL apheresis should be considered in the management of such pregnant cases. There are five different methods of selective LDL apheresis: heparin-induced extracorporeal LDL precipitation, double filtration plasmapheresis, direct adsorption of lipoproteins, dextran sulfate adsorption, and LDL immunoadsorption. The cascade filtration system is another modern and effective method for the extracorporeal elimination of LDL-C, although it is not as selective as the methods mentioned above. Herein, we present the case of a pregnant woman with heterozygous FH and extremely elevated LDL-C levels who has been successfully treated with the cascade filtration system until delivery. As far as we can ascertain, LDL apheresis with the cascade filtration system during pregnancy has not yet been reported in the literature.
authors.affiliation: Division of Endocrinology and Metabolism, Faculty of Medicine, Baskent University, Ankara, Turkey. e_ertorer@yahoo.com
authors.forename: Melek Eda
authors.initials: ME
authors.lastname: Ertorer
authors.forename: Birol
authors.initials: B
authors.lastname: Guvenc
authors.forename: Bulent
authors.initials: B
authors.lastname: Haydardedeoglu
authors.forename: Ferda
authors.initials: F
authors.lastname: Tekinturhan
mesh_terms: D000328:Adult; D001781:Blood Component Removal / Q000379:methods*; D002585:Cesarean Section; D008078:Cholesterol, LDL / Q000097:blood*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006440:Hemofiltration / Q000379:methods; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000235:genetics / Q000628:therapy*; D008991:Monitoring, Physiologic / Q000379:methods*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000628:therapy*; D011256:Pregnancy Outcome; D018570:Risk Assessment
chemical_list: D008078:Cholesterol, LDL